Form 2 Application for Eligibility Certificate by a Corporation (PDF ...

Office of Liquor, Gaming and Racing
COMPANY PROBITY FORM
(xviii) Is the company a trustee of any trust?
* YES / NO
If YES, provide full details:
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(xix) Is the company or the ultimate holding entity of the company listed on the
Australian Stock Exchange (or overseas equivalent)?
* YES / NO
If YES, has the listed company every been fined, suspended or reprimanded for
breaches of the Australian Stock Exchange (or overseas equivalent) listing rules?
If YES, provide full details:
* YES / NO
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(xx)
List the following details for each company auditor and external accountant
engaged over the last five (5) years:
Firm/Company
Address
Period of
Engagement
Signature: ___________________________________ 13